Atypical Vogt Koyanagi Harada disease

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Presentation transcript:

Atypical Vogt Koyanagi Harada disease Stephany Carrillo, Romina Muñiz, Alberto calvo, Carme macià, Antonio segura Hospital universitario general vall de hebron.

Clinical case 2007: A 37 year old female holocranial headache, metamorphopsia in her left eye, decreased visual acuity and redness in both eyes for 1 week. Nonreactive left pupil Biomicroscopy Endothelial KPs Tyndall +1 // +2 Normal Magnetic resonance imaging lumbar puncture and ORL evaluation BCVA RE: 20/50 LE: 20/200 Fundoscopy Vitritis +2, papillitis and retinal serous detachment

2007 Fundoscopy

2007 ANGiOGRAPHY

2007 retinal serous detachment

Course clinic Bilateral panuveitis 2007-2010 Multiple episodes of vitritis and snowball 2010 FACO + VPP + LIO LE + VPP RE 16/09/2010 CME RE 29/12/10 Axial psoriatic arthritis HLA B27 negative Diagnosis 19/04/2012 Vitiligo diagnosis 18/07/2013 FACO+ LIO + intravitreal triamcinolone RE 16/10/2014 Fundus depigmentation (multifocal choroiditis) HLA B29 negative 11/01/2016 CME LE

Cystoid MAcular edema evolution

Vitiligo diagnosis

bilateral fundus depigmentation

Right eye

LEFT EYE

Conclusion Despite the snowballs, CME, and the long timing between the first episode of vitritis and vitiligo diagnose, the acute stage and lately integumentary manifestations may be consistent with an atypical VKH.